| NPI | 1962162529 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KING HARRISON VP 202-807-5522 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 208D00000X General Practice |
| Enumeration Date | 2021-12-23 |
| Last Update Date | 2025-04-10 |